• Radiation Oncology Journal
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• 제16권4호
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• pp.357-366
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• 1998

Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week. 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4.1 Gy each to Point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as. 78-86$\%$ for Stage 1, 68-85$\%$ for stage 11, and 38-56$\%$ for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In addition, standardization of HDR application (clinical, computer algorithms, and dosimetric aspects) is necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1519-1523
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• 2015

Infection of the uterine cervix by human papilloma viruses (HPV) may be associated with cervical pre-cancer and invasive cervical carcinoma if left untreated. With advance in molecular techniques, it has become easier to detect the resence of HPV DNA long before the appearance of any lesion. This study concerned cervical scrape samples of 310 married non-pregnant women attending a gynecology outpatient department for both Pap and PCR testing to detect HPV DNA. Nested PCR using primers for L1 consensus gene with My9/My11 and GP6+/GP5+followed by multiplex PCR were carried out to detect HPV 16 and HPV18. Result: HPV prevalence was 11.9% out of which 3.67% cases of negative for intra-epithelial lesion or malignancy (NILM) and in 71.1% (27/38) of atypical cervical smears were HPV positive. There was increasing trend of high-risk-HPV positivity (HR HPV 16 and 18), from 20% in benign cytology (NILM) to 42.9 % in LSIL, 71.41% in HSIL and 100% in SCC. There was highly significant association of HPV infection with cervical lesion ($x^2=144.0$, p<0.01) and also with type specific HPV prevalence ($x^2=7.761^*$, p<0.05).

• Radiation Oncology Journal
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• 제29권3호
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• pp.214-217
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• 2011

To avoid improper tumor volume contouring in radiation therapy (RT) and other invasive procedures, we report a case of uterine adenomyosis showing increased $^{18}F$-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) mimicking malignant tumor in a 44-year-old woman during concurrent chemoradiation therapy (CCRT) for uterine cervical cancer. The adenomyosis was not associated with her menstrual cycle or with normal endometrium uptake, and it resolved one month after completion of RT. This case indicates that uterine adenomyosis in a premenopausal woman may show false positive uptake of $^{18}FDG$-PET/CT associated with CCRT.

• Radiation Oncology Journal
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• 제4권2호
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• pp.155-163
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• 1986

1983년 11월부터 1986년 2월까지 Fletcher-Suit-Delclos applicator를 이용하여 강내치료와 외부방사선치료를 완치목적으로 받은 자궁경부암환자 35국을 대상으로 소급하여 치료결과를 분석하였다. 환자의 나이는 32세에서 70세까지의 분포를 보였고 평균 나이는 53세이었다. 모든 환자에서 추적조사가 가능하였다. 추적조사 기간은 9개월에서 34개월이었고 평균 추적조사 기간은 20개월이었다. 병기별로 보면 1기가 4명, 2기가 25명, 3기가 5명, 그리고 4기가 1명이었다. 전반적인 관해율은 $80\%$이었고 2년 생존율은 $88\%$이었다. 방사선치료 후에 발생하는 합병증 중 특히 직장내 합병증을 분석한 바 최대직장조사량이 7000rad이하군에선 한명도 없었고 7000rad이상 조사받은 군에서는 17명중 2명에서 중간정도의 직장내 합병증이 나타났다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5653-5657
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• 2014

Background: To evaluate factors which effect treatment interruption during concurrent chemoradiotherapy (CCRT) and overall survival in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. Materials and Methods: Between January 2006 and December 2007, 107 patients with stage IB2-IVA as FIGO staging, 2000, were treated with CCRT in Srinagarind Hospital. Factors which caused treatment interruptions and impacted on overall survival were reviewed and analyzed. Results: Twenty of 107 patients had treatment interruption during CCRT in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. The causes of treatment interruption were as follows: hematologic toxicity was found in 16 of 20 cases, 12 cases with grade 2 and 4 cases with grade 3; three of 20 cases had gastrointestinal toxicities, 1 case with grade 2 and 2 cases with grade 3; one case had grade 3 skin toxicity. The mean total treatment time of the uninterrupted and interrupted groups were significantly different (78.98 days vs 161.80 days, p <0.001). The patients who could tolerate ${\geq}5$ cycles of cisplatin administration had significantly higher mean white blood counts (WBC) ($9,769cells/mm^3$ vs $7,141cells/mm^3$, p=0.02). The mean initial hemoglobin (Hb) in the uninterrupted group was significantly higher than the interrupted group (11.5 mg% vs 10.3 mg%, p=0.03). Other factors including age, KPS, initial platelets, initial serum creatinine levels showed no statistical significance. The 3-year overall survival of the uninterrupted group was better than in the interrupted group (78.6% vs 55.0%, p=0.03). Conclusions: The initial Hb and WBC levels were significantly correlated with treatment interruption during CCRT in patients with uterine cervical cancer. The 3-year overall survival of the uninterrupted group was significantly better than interrupted group. These factors may then be used indirectly to predict the outcomes of treatment.

• Radiation Oncology Journal
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• 제4권2호
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• pp.183-186
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• 1986

고선량율을 이용한 자궁강내 치료시 정확하고 신속한 계산을 위하여 저자들은 개인용 컴퓨터를 이용하여 기준점의 선량분포 및 방사선조사 시간을 간편하게 계산할 수 있는 software를 개발하였다. 치료 계획용 software를 이용하여 짧은 시간내에 선량 분포 및 조사시간을 용이하고 정확하게 계산할 수 있으며, 고선량을 자궁경부암 임상적응에 효과적으로 이용할 수 있어서 보고한다.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.159-172
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• 1996

A hospital-based case-control study was carried out to investigate the risk factors of uterine cervical cancer in Korea. Information on a wide-range of life-styles, which might be related with uterine cervix cancer, has been routinely collected through a dual application of the self-administered questionnaire and the direct interview by a well-trained nurse at the Department of Gynecology, Seoul National University Hosiptal since 1992. The number of cervical cancer cases, histologically confirmed at the hospital, were 284. Included were 939 women as controls, who were free of past history of any malignancies. Adjusted odds ratio and 95% confidence limits were based on the unconditional logistic regression model. The multivariate logistic model was constructed under the consideration of biologic characteristics on the natural history of the malignancy. In the multivariate results, the uterine cervical cancer risk was higher in women of shorter height$(P_{trend}<0.05)$, less educated spouse$(P_{trend}<0.001)$(0.001), multiple marriages(adjusted OR=2,70, 95% C.I. $1.64\sim4.47$), ever had a family history (adjusted OR=2.14., 95% C.I. $1.18\sim3.89$), multiparity$(P_{trend}<0.001)$, and early age at first $(P_{trend}<0.001)$. These results strongly suggest that the uterine cervix cancer might be related to the reproductive factors, and probably with sexual behaviour of both women and men in Korea.

• Journal of Preventive Medicine and Public Health
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• 제35권3호
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• pp.263-268
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• 2002

Objective : This study was aiming at estimating the joint effects of various risk factors associated with uterine cervix cancer in Korea. Methods : Data obtained from a case-control study were analyzed with a multiplicative model. Results : After adjustment for age and husband's educational attainments, the family history of cervical cancer (OR=2.1, 95% CI=1.2-3.9), unstable marital status due to separation, by death or divorce, etc. (OR=2.8, 95% CI=1.7-4.6), and a large number of deliveries ($\geq$3 vs. nulliparous OR=6.5, 55% CI=1.4-29.0) increased the risk of uterine cervix cancer, Conversely, first sexual intercourse at an older age ($\geq$25 years vs. <19 years OR=0.4, 95% CI=0.2-0.6) and husband's circumcision (OR=0.7, 95% CI=0.5-1.0) decreased the risk. In the multiplicative model, the highest joint risk (OR=39.2, 95% CI 5.9-258.9) was observed in women with a family history of uterine cervical cancer, an unstable marital status, where the ex-husband was not circumcised, with 3 or more delivery experiences, and having her first sexual intercourse when younger than 19 years of age. However, women without a family history of uterine cervix cancer, married to a circumcised husband, having had her first sexual intercourse at 25 years or older, and nulliparous, showed the lowest joint effect (OR=0.3, 95% CI=0.1-0.5). Conclusion : As carcinogenesis is a complex action involving various factors, we consider a joint effects approach to be appropriate in an epidemiological study on risk factors for uterine cervix neoplasms cervix neoplasm.

• 가정∙방문간호학회지
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• 제23권2호
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• pp.166-176
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• 2016

Purpose: The purpose of this study was to investigate the knowledge and prevention attitudes of female North Korean refugees regarding cervical cancer and human papillomavirus(HPV) infection. Methods: A descriptive study was conducted. Data were collected from November 2015 to March 2016 and 130 female North Korean refugees participated. Data were analyzed using SPSS 21.0. Results: Score on knowledge and prevention attitudes regarding cervical cancer and HPV were 2.53 out of 8 points, 1.67 out of 17 points, and 28.90 out of 36 points. There were significant differences between entry duration, the number of children, previous cervical cancer tests, Precognition about HPV, preferred education method, and knowledge of cervical cancer. There were significant differences between previous cervical cancer tests, Precognition about HPV and knowledge of HPV. The correlation between knowledge and prevention attitudes regarding cervical cancer and HPV was significant positive. Conclusion: Female North Korean refugees' knowledge level of cervical cancer and HPV is very low. However, their attitudes towards prevention was higher. These results imply a need for education, aimed at guiding North Korean female refugees, so as to enhance their knowledge regarding cervical cancer and HPV, and to promote their sexual health.

• 대한방사선치료학회지
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• 제7권1호
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• pp.133-145
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• 1995

1. Purpose : 30 patients with uterine cervical cancer who had been treated at Department of radiation Oncology of Korea university Hospital from June, 1, 1994. to December. 31, 1994. were analyzed to the radiation field accuracy using verification films. 2. Methods and Materials : 30 patients were divided by 6 groups, 5 patients respectively : Group (1) : Standard physique, supine not-fixed Group (2) : Standard physique, supine fixed Group (3) : Obesity physique, supine, not-fixed Group (4) : Obesity physique, supine, not-fixed Group (5) : Obesity physique, prone, not-fixed Group (6) : Obesity physique, prone, fixed All groups were taken verification fimls during the whole treatment period, and it compared with simulation films and portal fimls, 3. Results : This results suggest that all patients should be immovilized and especially obesity physique patients should be treated by prone position in order to reduce radiation field discrepancy. In addition, this results should help to prescribe appropriate safty margins for patients simulation.